Access to breast cancer wonder drug will depend on where you live

Access to a potentially life-saving breast cancer drug in the UK has nothing to do with need but rather where they happen to live.

Women who live in Wales are able to receive the treatment at the Royal Shrewsbury hospital free of charge, while those just across the border in Shropshire have to pay the cost of £47,000 themselves, because the revolutionary new drug Herceptin is not funded by their health board.

This graphic inequality is an illustration of the differences in priorities between different health authorities.

The Welsh Assembly government agreed last February to pay for the drug for women living in Wales who need it, even if they are treated in England.

In England the drugs use is largely restricted to patients with an advanced stage of the cancer and approval for its use in early stage breast cancer has yet to be granted by the National Institute for Health and Clinical Excellence (NICE), the body that determines the cost effectiveness and efficacy of treatment.

That decision is expected later in the year.

Despite Patricia Hewitt, the health secretary, saying that health trusts should not turn down Herceptin on the basis of cost alone, the trusts are not obliged to follow this suggestion and, with a year's supply costing almost £30,000, many are waiting for NICE's guidance.

Herceptin has been hailed as a "wonder drug" and works by targeting the HER-2 protein, which can fuel the growth of breast cancers, and stopping this process happening. But it only works on the 20% of breast cancers that are HER-2 positive.

It has been claimed to halve the chances of the aggressive HER-2 form of breast cancer returning but in reality, almost 10 % of the women on the British trial found their cancer returned compared with 17.2% who did not have the drug.

Some concerns have also been voiced that the drug may be linked to heart problems; however a number of breast cancer patients denied the treatment have taken their fight to access the drug to the European courts.